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<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<%@ taglib prefix="s" uri="/struts-tags" %>


<html>
<head>

        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
        <meta name="description" content="Reflect Template" />
		<meta http-equiv="X-UA-Compatible" content="IE=EmulateIE7" />
        <title>Add Alergy Details</title>
        <link rel="stylesheet" href="css/style_all.css" type="text/css" media="screen" />



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        <script type='text/javascript' src='js/jquery-ui.js'></script>
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        <script type='text/javascript' src='js/custom.js'></script>
    </head>
<body>
<form action="askDoctorDet">
<table width="80%" border="1">
  <tr>
    <th scope="col" colspan="3" align="left">&nbsp;Doctor Details</th>
   </tr>
  
</table>

<table width="75%" border="0">
  <tr>
    <td>Title</td>
    <td>&nbsp;</td>
    <td>&nbsp;<input name="title" type="text">
            </td>
  </tr>
  <tr>
    <td>FirstName</td>
    <td>&nbsp;</td>
    <td>&nbsp;<input name="fname" type="text">
            </td>
  </tr>
  <tr>
    <td>Last Name </td>
    <td>&nbsp;</td>
    <td>&nbsp;<input name="lName" type="text">
            </td></tr>
			 <tr>   <td>Contact No </td>
               <td>&nbsp;</td>
    <td>&nbsp; 
            </td>
  </tr>
  
  
 
    <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;
      <input type = "submit"  name="SubmitDoctor"/></td>
  </tr>
</table>
</form>
</body>
</html>